Revenue Cycle Specialist
About The Position
A Revenue Cycle Specialist manages the healthcare billing process from patient intake to final payment, ensuring accurate reimbursement, claim submission, and denial management. They verify insurance, handle collections, and maintain compliance with regulations to optimize revenue. Key skills include, but are not limited to, proficiency in medical billing, ICD-10/CPT coding, and navigating EHR systems. Essential Functions: Reviewing, submitting, and tracking insurance claims to ensure timely, accurate reimbursement. Investigating, appealing, and resolving denied or rejected claims. Verifying insurance coverage, calculating patient costs, and arranging payment plans. Monitoring aging reports, following up on outstanding balances, and reducing A/R days. Ensuring all billing activities follow regulations and conducting internal audits. Responsible for performing all medical records coordination for all agency patient charts. In-depth proficiency in medical terminology, the application of ICD-10, CPT, and HCPCS coding guidelines with the ability to assign codes and properly sequence. Proficiency in electronic health record (EHR) systems and billing software. High attention to detail, strong communication skills, and ability to handle confidential information. Demonstrates courteous, professional, and confident rapport with customers/significant other(s), offers informative and accurate communication. Works in collaboration with all staff members to ensure optimum care to patients and customers. Maintains confidentiality. Models appropriate behaviors and maintains proper boundaries when interacting with co-workers, patients, families, vendors, and customers. Follows company policies to ensure consistent and compliant job performance. Performs all other duties as assigned.
Requirements
- High school diploma or equivalent.
- Previous experience in healthcare billing, collections, or medical insurance.
- Excellent written and verbal communication skills
- Strong customer service skills
- Ability to multi-task, prioritize and direct staff
- Excellent computer skills including working knowledge of Word and Excel
- Data entry and medical terminology knowledge
Nice To Haves
- Associate or bachelor’s degrees preferred.
- Relevant industry experience preferred.
- Active CPC credential from the AAPC, highly preferred
Responsibilities
- Reviewing, submitting, and tracking insurance claims to ensure timely, accurate reimbursement.
- Investigating, appealing, and resolving denied or rejected claims.
- Verifying insurance coverage, calculating patient costs, and arranging payment plans.
- Monitoring aging reports, following up on outstanding balances, and reducing A/R days.
- Ensuring all billing activities follow regulations and conducting internal audits.
- Responsible for performing all medical records coordination for all agency patient charts.
- In-depth proficiency in medical terminology, the application of ICD-10, CPT, and HCPCS coding guidelines with the ability to assign codes and properly sequence.
- Proficiency in electronic health record (EHR) systems and billing software.
- High attention to detail, strong communication skills, and ability to handle confidential information.
- Demonstrates courteous, professional, and confident rapport with customers/significant other(s), offers informative and accurate communication.
- Works in collaboration with all staff members to ensure optimum care to patients and customers.
- Maintains confidentiality.
- Models appropriate behaviors and maintains proper boundaries when interacting with co-workers, patients, families, vendors, and customers.
- Follows company policies to ensure consistent and compliant job performance.
- Performs all other duties as assigned.
Benefits
- We offer a robust benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, short-term and long-term disability, and a generous time off package.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
101-250 employees
